Tuesday, March 28, 2006

PTSD Stalks Veterans, Civilians

Tuesday, March 28, 2006

BY JOHN HALE

AUGUSTA - Until 1980, it didn't have an official name.

But soldiers in all the wars in history, dating back to the Egyptians and the Greeks, had suffered from it.

Some called it shell shock, others called it battle fatigue.

In 1980, the American Psychiatric Association officially dubbed it Post Traumatic Stress Disorder, or PTSD, an anxiety disorder that curses people who are forced to relive an emotionally stressful event over and over again.

It's particularly acute for battlefield soldiers. But civilians in stressful situations also can get PTSD. Survivors of terrorists attacks like 9/11 or natural disasters like Hurricane Katrina can get PTSD. So can battered wives and abused children.

On Saturday, from 9 a.m. to 3 p.m. at the Senator Inn in Augusta, Maine Veterans for Peace is sponsoring a symposium on PTSD. The fee at the door will be $10 per person and $25 for health professionals, which includes lunch.

“We won't turn anyone aside if they can't afford it,” said Doug Rawlings, president of Maine Veterans for Peace, who is hoping for a large turnout.

“It's tough to deal with,” Rawlings said. “One of the symptoms of PTSD is you don't want to be around groups. To encourage people to come out to a symposium is a delicate task.”

The symposium has two featured speakers.

Bruce Letch is a clinical psychologist in the Psychiatry Department at Togus veterans hospital who has been treating PTSD patients since 1980.

Glenn Schiraldi is a public-health educator on the stress management faculty at the University of Maryland and formerly on the stress management faculty of the Pentagon. He is author of “The Post Traumatic Stress Disorder Sourcebook.”

PTSD first came to the public's awareness after the Vietnam War as thousands of returning veterans experienced flashbacks, nightmares and social withdrawal.

Now, thousands of returning veterans from Iraq and Afghanistan are reporting the symptoms of PTSD.

Laurie Tranter, a spokeswoman for the Department of Veterans Affairs in Washington, said that a total of 505,366 veterans have already returned from active duty in Iraq and Afghanistan.

Of that total, 144,424 veterans have sought medical help in VA hospitals and clinics and 20,638 veterans have been given the initial diagnosis of PTSD. That's about 1 in 25 veterans who served in Iraq or Afghanistan, but the Department of Veterans Affairs doesn't think all veterans who need help have come forward.

“It's probably going to end up being similar to Vietnam,” Schiraldi said.

According to the “Diagnostic and Statistical Manual of Mental Disorders,” the Bible of the mental-health profession, PTSD has to have four conditions in order to be present. They are:

€ Exposure to an initial stressful event.

€ The event is reexperienced through nightmares or flashbacks or unwanted memories.

€ There is trouble falling asleep, angry outbursts, difficulty concentrating, hyper-vigilance and exaggerated startle response.

€ In the avoidance or numbing cluster, people with PTSD try to avoid anything that reminds them of what happened. People may become socially withdrawn. They may avoid crowds. They may not be interested in parties, sex or hobbies. They feel like they may never have a normal life again.

Schiraldi said there a number of ways of treating PTSD, most of them centered on talking therapies.

“You take this memory that's sitting there like an angry child in a playpen and you try to calm it so you can put it away,” he said. “You try to neutralize the memory, which is intruding, put the pieces together and then store it in long-term memory.”

He said therapy for PTSD patients usually follows a sequence, such as:

€ Educating the person - normalizing the symptoms and understanding the symptoms.

€ Stabilization phase - making sure they're not harming themselves.

€ Managing the symptoms.

€ Cognitive behavioral treatments - These include correcting unreasonable negative memories such as “I'm responsible for losing my squad members when we were attacked.”

Various skills are used for expressing the memories and bringing the traumatic memory to awareness. Schiraldi said art therapy can be very effective.

“If a soldier comes in with unresolved trauma from his earlier life, such as child abuse, they're more vulnerable to getting PTSD from combat duty,” Schiraldi said.

€ “Group therapy can be very helpful, especially for soldiers who feel that nobody but other soldiers can understand what they've been through,” Schiraldi said.

€ Serotonin enhancers that are used to treat depression such as Zoloft have been found to be effective medications to combat PTSD.

“Mental-health professionals have many more tools than they used to have and so the prognosis is much brighter,” Schiraldi said. “Individuals would be wise to seek a trauma specialist, not just a generic counselor. Sometimes just talking about it is not just enough.”

He said the Sidran Institute in Maryland keeps a registry of trauma specialists.

“There is some evidence that you don't want to wait, that the sooner you get treated, the better your prognosis,” Schiraldi said. “Some people suffer for decades, not realizing that if they got treatment, their suffering would lessen quickly.”

“The more you keep these memories secret, the more they will eat away at you,” he said.

Schiraldi said many members of the World War II generation masked their painful war memories by drinking, and not talking about them for decades.

He said a U.S. naval veteran who was in a Kamikaze attack in the Pacific on a warship had all his memories flood back over him almost 60 years later when he saw the World Trade Center attacked by terrorists on Sept. 11, 2001. n

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